Moduladores alostéricos del receptor sensible al calcio e hiperparatiroidismo primario

Endocrinología y Nutrición 05/2008; 55(5). DOI: 10.1016/S1575-0922(08)70667-3
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  • Journal of Clinical Endocrinology &amp Metabolism 01/2003; 87(12):5353-61. DOI:10.1210/jc.2002-021370 · 6.21 Impact Factor
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    ABSTRACT: It is unclear whether patients with asymptomatic primary hyperparathyroidism (PHPT) do better with parathyroidectomy (PTx) as compared with conservative medical management. The aim of the study was to evaluate the beneficial effect of PTx vs. conservative management in patients with mild asymptomatic PHPT. We conducted a prospective, randomized study. The study took place at a referral center. We studied 50 patients who did not meet any guidelines for parathyroid surgery as recommended by the National Institutes of Health Consensus Development Conference on Asymptomatic PHPT. Patients were randomly assigned to PTx or no PTx and were evaluated at 6 months and at 1 yr. We compared changes (percentage of basal) of lumbar spine bone mineral density (BMD) between the two groups at 1 yr. The change in BMD at lumbar spine was greater after PTx (+4.16 +/- 1.13 for PTx vs. -1.12 +/- 0.71 for no PTx; P = 0.0002). The change in BMD at the total hip was also significantly greater in the PTx group (+2.61 +/- 0.71 for PTx vs. -1.88 +/- 0.60 for no PTx; P = 0.0001). There was no difference in BMD after 1 yr between both groups at the one-third radius site. In comparison with those who did not undergo surgery, the PTx subjects, after 1 yr, showed significant differences in four quality of life measures as determined by the 36-item short form health survey scale: bodily pain (P = 0.001), general health (P = 0.008), vitality (P = 0.003), and mental health (P = 0.017). In patients with mild asymptomatic PHPT, successful PTx is followed by an improvement in BMD and quality of life. Most patients followed without surgery did not show evidence of progression.
    Journal of Clinical Endocrinology &amp Metabolism 09/2007; 92(8):3114-21. DOI:10.1210/jc.2007-0219 · 6.21 Impact Factor
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    ABSTRACT: The aim of this study was to investigate the risk of death among patients treated for primary hyperparathyroidism during the past decade. Using the national patient register, all patients operated on for primary hyperparathyroidism in Sweden during 1987-94 were identified and then searched for in the national register of deaths and causes of death during the same period. The control group was the whole Swedish population, matched for age, sex and calendar year. We found that patients treated for primary hyperparathyroidism run an increased risk of death. The risk ratios for death from cardiovascular disease were 1.71 for male and 1.85 for female patients. These estimations are of high precision because of the large patient series (n = 4461), with 95% confidence limits of 1.34-2.15 and 1.62-2.11 for men and women respectively. This finding, together with previous findings that parathyroid adenoma weight, serum calcium level and parathyroid hormone level are predictive of the risk of death, suggests the possibility that surgery in patients with primary hyperparathyroidism may offer not only relief from signs and symptoms but also improved prognosis.
    European Journal of Clinical Investigation 05/1998; 28(4):271-6. DOI:10.1046/j.1365-2362.1998.00289.x · 2.73 Impact Factor
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